The article analyzes the effectiveness of a selective preventive fluorographic examination of a socially maladjusted group of the population, conducted in Yakutsk in 2018-2021. The socially maladjusted groups of the population include persons without a fixed place of residence and work (homeless), suffering from alcohol addiction, persons released from places of the penitentiary system. The analysis of data from field fluorographic examinations of 667 persons from a socially maladjusted group who found themselves in difficult life situations was carried out. The examination revealed 114 fluoropositive individuals with various radiographic changes in the chest organs. As a result of additional examination of fluoropositive persons in the anti-tuberculosis dispensary, active tuberculosis of the chest organs was detected in 7 persons, metatuberculous changes in the lungs - in 28, oncological and non-specific inflammatory diseases, as well as post-inflammatory changes in the lungs - in 41. The group of the population amounted to 10.5 per 1,000 examinations, which is significantly higher than the similar indicator of mass continuous examination of the entire population of the republic for 2012-2019, which amounted to 0.57 per 1,000 examinations.

Thus, persons from the socially maladjusted group of the population remain one of the main risk groups for tuberculosis. Tuberculosis remains largely a social disease and requires special attention not only from healthcare organizations, but also from social protection authorities, administrations of municipal institutions, public organizations, law enforcement and justice agencies.

Suicide prevention is an important task of modern society for the World Health Organization (WHO). For the Russian Federation, the problem of suicidal behavior of the population is an urgent problem. There are regions in the country with an ultra-high suicide index (more than 60 cases per 100 thousand population). They are located in the North of the country and in most cases are ethnic entities. In this regard, a systematic study of the regional and ethno-cultural features of the suicidal situation in the country is required. Research methods: Within the framework of the study, a clinical and epidemiological analysis of the frequency of suicides in the districts of the Republic of Sakha (Yakutia) over the past 5 years (2016, 2017, 2018, 2019 and 2020) was applied. An average suicide index for five years was revealed for each district and for the Vilyuisk group of districts. Research results: 1. The average suicide index for five years in the Republic of Sakha Yakutia was 25 per 100 thousand population. This indicator is more than 2.5 times higher than the global average and
2 times higher than the Russian indicators. 2. Areas with an ultra–high level of committed suicides (more than 60 cases per 100 thousand population) have been identified – these are Anabarsky, Srednekolymsky and Eveno-Bytantaysky. The highest suicide rate was detected in the Srednekolymsky district – 93.8 cases of suicide per 100 thousand population. 3. Five districts with a high suicide rate have been identified (from 40 to 59 cases per 100 thousand population). 4. 22 districts with moderate suicide rates were identified (20-39 cases per 100 thousand population). 5. 3 districts and a city with low suicide rates have been identified (0-19 cases of suicide per 100 thousand population). 6. The average suicide index for the Vilyui group of districts was 32. This indicator is 1.3 times higher than the republic’s index. Conclusion: 1. In areas with extremely high suicide rates, mainly representatives of the indigenous peoples of the North live. 2. Ultra-high suicidal activity indicates insufficient socio-economic development in the above-mentioned areas. 3. The basic psychological need of indigenous peoples – the affiliation need remains unsatisfied. 4. The high suicidal activity of representatives of indigenous peoples indicates their alienation from the culture of their people. 5. Relatively high suicide rates in the Vilyuisk group of districts may be caused by a violation of the ecological balance in the «man – environment» system due to negative anthropogenic impact. 6. Suicide mortality depends on the average age of the district population – the older the population, the higher the suicide index.

The process of eruption of temporary teeth serves as an indirect indicator of the physical development of the child, reflects the state of health of children in the first year of life, which emphasizes the need to study biomedical factors affecting the development of children and their health. The article presents the results of a comprehensive dental study of young children living in Krasnoyarsk. Correlation analysis between biomedical factors of the gestation and delivery period and the postnatal period in children of the research population revealed a weakly expressed correlation coefficient between the timing of eruption of individual groups of temporary teeth and perinatal damage to the central nervous system in children. Meanwhile, pronounced dependencies were determined between the timing of individual groups of teeth and the biomedical factors of the gestation and delivery period in the control group of the research, several were identified. The most active influence on the eruption timing is the perinatal lesion of the central nervous system of hypoxic genesis suffered by the child. In general, it has been established that biomedical factors play an important role in the formation of child health, and also significantly affect the formation of temporary bite.

Cognitive impairment and dementia are an relevant problem of modern neurology and psychiatry, which is explained by their wide prevalence, as well as the predicted increase in the number of patients in the future. However, dementia in most cases does not occur acutely, its development is preceded by a long period when cognitive impairments do not disrupt the patient’s everyday and professional life yet. Such cognitive impairments are called “pre-dementia” and are divided into subjective, subtle, and mild. With subjective cognitive impairment, patients present complaints; however, neuropsychological testing does not reveal decreased cognitive functions. Subtle cognitive impairment is accompanied by a decrease in cognitive functions when using highly sensitive scales. This article provides an overview of current data on the definition, classification, diagnosis, and treatment of mild cognitive impairment (MCI) from the point of view of the evidence-based medicine for timely diagnostics of the state and its effective correction. In patients with MCI, in addition to complaints of cognitive deficit, it is detected during screening neuropsychological testing; but unlike dementia, it does not impair the patient’s functionality. MCI is a leading risk factor for future dementia. However, according to research, cognitive deficits can not only progress, but also stabilize and even regress. In this regard, it is important to identify patients with MCI on time, establish nosological affiliation for correcting risk factors and prescribing treatment. The most common causes of MCI can be neurodegenerative disorders (primarily Alzheimer’s disease) and cerebrovascular diseases. The authors present the diagnostic value of popular scales such as the Mini-Mental State Examination, the Montreal Cognitive Assessment Scale and the 3-CT test in the diagnosis of MCI. The possibilities of using biomarkers, such as the determination of beta-amyloid and tau-protein in the cerebrospinal fluid, and the detection of signs of neuronal damage during neuroimaging of the brain, are discussed. It is stated that the most proven methods of influencing cognitive deficits in MCI are non-drug measures.

The experience of using the inhaled drug Surfactant-BL in patients with tuberculosis of the respiratory organs on the background of standard chemotherapy is presented, taking into account the drug sensitivity of Mycobacterium tuberculosis. The epidemic situation of tuberculosis in the Republic of Sakha (Yakutia) has positive trends: the incidence rate of tuberculosis has decreased by 1.6 times, amounting to 28.6 per 100,000 population in 2021; the prevalence of tuberculosis in the republic in 2021 reached 56.2 per 100,000 population (-34.8 % compared to 2019). Despite the decrease in tuberculosis bacillarity (by 1.5 times compared to 2019), the multidrug resistance (MDR) of the pathogen continues to remain at a fairly high level, amounting to 29.5 % – 31.7 %. Patients are prescribed chemotherapy with 5 anti-TB drugs, against the background of which inhalation of surfactant significantly facilitates sputum discharge, and therefore contributes to the rehabilitation of decay cavities, accelerates the disappearance of symptoms of tuberculosis intoxication.The article presents two clinical cases, demonstrating the effectiveness of complex therapy in a patient with newly diagnosed destructive tuberculosis of the respiratory system and a patient with diagnosed mycobacteriosis.

The article provides an overview of the areas of application of chatbots, as well as discusses the prospects for their use in the practice of an ophthalmic hospital. A literature review shows that the introduction of a chatbot in the State Autonomous Institution of the Republic of Sakha (Yakutia) “Yakut Republic’s ophthalmological clinical hospital” (YROCH) was carried out for the first time in the Russian Federation and showed the effectiveness of using modern technologies to increase the availability of information about the services provided, feedback from the medical organization. A scientific hypothesis has been proven that the use of a chatbot as a round-the-clock feedback tool in the YROCH allows you to unload the staff of the contact center of the hospital, improves the economic performance of making an appointment for an initial appointment in the direction of “Paid Services”. The research is divided into three stages. At the first stage, a sociological survey of 209 residents of the city of Yakutsk was conducted, which showed that its population is ready to use modern information technologies. The second stage was the creation of a chat bot based on the Telegram platform and testing it for a month as a feedback tool in the practice of the YROCH. This significantly relieved the work of the Contact Center for registering for paid services, satisfying the needs of patients for round-the-clock information provided. The third, experimental, stage showed significant savings in human and time resources.

Although the adoption of chatbots in the healthcare industry is rather slow, their adaptability to the infrastructure of a medical organization is much faster. Interactive chatbots are playing a new role in improving the efficiency of healthcare professionals. The use of the chatbot in the YROCH had a positive impact on the work of the hospital, informing the population. Efficiency in the application of the organization of paid medical services was confirmed by an increase in economic indicators, an increase in the number of clients undergoing extrabudgetary services, and a decrease in labor costs for the operation of the hospital’s contact center.

The formation of geochemical anomalies in Zabaikalsky Krai is associated with the activities of mining enterprises. Over a long period of mining operations in Eastern Zabaikalsky Krai, a significant number of objects of accumulated environmental risk have formed, many of which are located in the vicinity of settlements. Mining wastes pose a potential hazard to the soil, underground and surface water sources, and atmospheric air pollution by a wide range of chemical elements. Arsenic, lead, zinc, cadmium, bismuth and tin are the most common chemical elements exceeding hygienic standards. As a result of a study of the water quality of surface water bodies, drinking water of centralized and non-centralized water supply systems, and the state of the soil cover in the territory of Klichka settlement (Priargunsky District), it was established that in the water of noncentralized and centralized drinking water supply sources the excess of hygienic standards for arsenic and chromium was 2.0 – 5.8 TLV and 1.2 TLV, respectively. The maximum excess of the normative values for arsenic, lead, cadmium and zinc was detected in technosol, which are 200.5, 47.2, 14.0 and 5.5 times, respectively. An assessment of children’s health risk from chemical pollution of drinking water shows that the coefficient of non-carcinogenic hazard for most of the studied chemicals does not exceed the allowable value (HQ = 1.0) the exception is the hazard ratio associated with exposure to arsenic (HQ = 2.50). When calculating the total hazard index for the simultaneous ingestion of chemicals, it was found that for the child population the HQ was 4.12, with arsenic making the greatest contribution to the value of the index. The results obtained indicate the need for further study of environmental factors and in-depth biomedical research.

Assessing the level of physical development of individual population groups is necessary for the formation of a personalized approach in medicine. The purpose of the study was to develop centile tables on anthropometric and bioimpedance parameters of young men in the Sakha Republic (Yakutia). The young men of the Yakut ethnicity aged 17-21 years were examined; under the age classification of human ontogenesis, they belonged to the youth age period. Anthropometric measurements were carried out according to the classical method of V.V. Bunak. The length and weight of the body, the girths of the chest, waist and buttocks are determined. Absolute and relative values of the main components of the body were determined by bioimpedance measurement (BIA). The analyzer of body composition and balance of water sectors of the body ABC – 01 “Medass” was used. Measurements were carried out according to a standard four-electrode scheme with the attachment of disposable electrodes (Shiller Biotabs® with Ag/AgCl coating) in the area of the wrist and ankle joints. The obtained material was processed by the method of variation statistics using the SPSS 17.0 application software package. To assess the distribution of anthropometric and bioimpedance indicators of young men in Yakutia in percentage terms, a centile analysis was carried out. The cents P5, P10, P25, P75, P90, P95 were applied. The study revealed regional peculiarities of overall dimensions and body composition of young Yakut men. Lower indicators of body weight, fat mass, active cell mass and musculoskeletal mass of Yakuts were established in comparison with the data of young men from other regions of Russia. Centile tables of parameters of body length and weight, girth dimensions of the chest, waist and buttocks, body mass index, bioimpedance indicators of fat mass, active cell mass, musculoskeletal mass, lean mass of Yakut boys were developed. These tables allow us to assess the level of physical development of young Yakut men for the formation of a personalized approach in medicine. The results obtained can be used in conducting comparative analyses with the indicators of young men living in other regions.

The level of formation of school maturity directly depends on the health of preschool children. In order to assess the psychophysiological readiness for schooling of frequently ill children, 77 preschool children attending preparatory groups of kindergarten No. 8 “Rodnichok” in Yakutsk were examined. According to the results of the medical examination, 7.7 % of children belonged to the 1st health group, 81.8 % – to the 2nd group and 10.5 % of children – to the 3rd health group. Children of the 3rd health group suffered from respiratory diseases more than 7-8 times during the year and had monthly absences on average from 8 to 12 days. Diagnostics of the readiness of future first–graders to study at school was carried out using the Kern-Yerasek psychological test aimed at identifying psychosocial maturity, the level of development of visual-motor functions and speech, as well as school-necessary functions in the form of the ability to arbitrary behavior. According to the results of the study, 67.5 % of the children were ready for school (who showed a high level of development on all tests), 19.5 % had an average level of “school maturity”, and 1.3 % of children had a low level. Assessment of psychological readiness to study at school according to all components of the Kern–Yerasek test allowed us to conclude that frequently ill children, without statistically significant differences from healthy peers in terms of the development of visual-motor coordination, lag behind them in terms of the development of social qualities associated with general awareness, which may be a significant reason violations of children’s adaptation to school. The results of the study indicate the need for a targeted examination of children before entering school, and the preparation of frequently ill children for systematic schooling using special health-saving programs.

Innovative developments in medicine most effective when it utilizes an integrated multidisciplinary approach, the solution to the modern challenges in medical science requires new approaches and keys. And this is not only about the interaction and complementarity of medical disciplines, but the solution of problems regarding related sciences including physics, biology, chemistry, mathematics, information technology and others. The rapidly changing field of medicine and healthcare increasingly adopts scientific and technological innovations, making interdisciplinary collaborations especially important. Along with the continuing disciplinary organization of science there is rapid expansion of interdisciplinary knowledge, problematic approaches to research are increasingly being used, and the paradigm of integrity obtained within individual scientific disciplines is being affirmed.